Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

Wednesday, December 19, 2012

WOW!!! It’s hard to believe that this is the last blog
for 2012. In looking back through the blogs that were written it is truly
amazing to realize just how broad the range of topics was!

2012 saw the continuation of the Guest Blogger concept
with eight (8) different bloggers.Each
is respected in their field and lends their expertise and insight to the Talk
Clean to Me Blog on topics pertaining to cleaning and disinfection. We would
like thank Mark Heller (Environmental Services Specialist & B2B
Consultant), Jason Tetro (The Germ Guy blog), Paul Webber (Webber Training & the global teleclass concept), Darrel Hicks (author of Infection Prevention for Dummies), Jim Gauthier (Infection Prevention & 2012 CHICA
Canada President), Rick Wray (Pediatric Patient Safety & Infection
Prevention), Dr. Lucas Panteleon (Veterinarian & Animal Infection
Prevention), and Professor Ewen Todd (Michigan State University and Guest
Blogger on the DEB Hand Hygiene Blog) for their support in 2012! We will
continue to introduce you to Guest Bloggers from around the world and also hope
to introduce you to some of the blogs we think are worthy of following.

We also introduced a monthly Chemistry Blog in 2012 and
will continue to expand our education on chemical actives used for cleaning,
sanitizing and disinfection of surfaces, devices and hands in 2013. The focus
of the Chemistry Blogs this past year revolved around the actives most found in
products uses for surface cleaning and disinfection (Quats, Chlorine,Phenols,
Hydrogen Peroxide, Ozone, Alcohols, Silver Dihydrogen Citrate, Organic Acids,
Peracetic Acid and Improved Hydrogen Peroxide). Next year, we’ll focus on the
chemistries used for hand hygiene and medical device reprocessing and hope our
chemical geekiness will in some way lead to frank and educational discussions
around the cleaners and disinfectants that we chose and use.

To continue our infection prevention education (a true
passion of mine) we will be introducing a “Bug Blog” in 2013. We have from time
to time dedicated a blog to a specific bug (i.e.,Norovirus, The Cold or Flu
etc), based on the time of year or “exciting” events in microbiology (stay
tuned for a blog on the new novel Coronavirus!) and for 2013 we want to
continue this focus so we not only know about the bug, but better understand
how disinfectants “attack” and “kill” the bugs we are concerned with.

Of course, we will be sure to blog about any topic or
newly published science that goes with the Talk Clean To Me mandate to educate
and provide you the latest resources related to cleaning and disinfection of
environmental surfaces, medical devices and hands. It’s true, our commitment to
providing chemical disinfectant education is more than business, it is a
passion!

We would like to wish you a
Happy Holidays and hope that you continue to follow us in 2013!

Friday, December 14, 2012

With Christmas holidays around the corner and almost
daily updates on new outbreaks associated with respiratory or gastro nasties, I
thought it prudent for the focus of this week’s blog to be on Holiday Infection
Prevention.

We are, without a doubt, well into cold and flu season
and while we bandy about the terms “cold” and ”flu”, there are certainly more
nasties out there than just the cold and flu. The following list is what Public
Health Units from across North America are currently seeing in terms of the
bugs implicated in some of the outbreaks so far.

Symptoms: Influenza is characterized by sudden onset of
high fever (38 C-39 C/100 -103 F), cough (typically dry), headache, muscle and
joint pain, severe malaise, sore throat and runny nose.Illness is self-limiting and most people
recover within a week. It can be indistinguishable from the common cold in the
early stages but the flu can be identified by the high fever and extreme
fatigue.

Transmission is Airborne (when someone inhales the
aerosols produced by an infected person coughing, sneezing or spitting) can
also spread through Indirect Contact (fecal to oral route);

Symptoms: Most infections result in upper respiratory
tract infections.It can also manifest
as croup, conjunctivitis, tonsillitis, or ear infections. Adenovirus can also
cause gastroenteritis resulting in diarrhea.

Now that we know who we are trying to fight off, what can
we do to stay healthy?Proper hygiene
(cleaning and disinfecting hands and surfaces) and practicing social distancing
is the primary means to help stop the spread of the bugs we see during “Cold
& Flu Season”.Approximately 80% of
infections are transmitted by hands.Frequent washing of hands with both soap and water or alcohol hand
sanitizers is the single most effective way of limiting the spread of the “Cold
& Flu Season” bugs.Hands should be
washed after blowing ones nose (and especially after blowing someone else’s
nose!) , after covering your mouth after coughing or sneezing, after using the
bathroom and most definitely prior to eating or drinking.Social distancing means reducing the
frequency, proximity, and duration of contact between people (i.e. employees,
customers and of course small children) to reduce the chances of spreading the
“Cold & Flu Season” bugs from person-to-person.While this is not always possible we can
take the opportunity to turn our heads and cover our mouth and nose with our
elbows when we cough and sneeze.Using
our elbows to cover our mouth and nose helps to keep our hands free of germs
which could spread disease.

“Cold & Flu
Season” bugs can also be spread by touching objects contaminated with the
nasties and then transferring the bug from the hands to the nose, mouth or
eyes.High touch hand contact surfaces
such as door knobs, light switches, telephones, keyboards etc should be cleaned
and disinfected frequently.During “Cold
& Flu Season” you can help stop the spread by cleaning and disinfecting
your work areas before going on breaks, lunch and prior to leaving at the end
of the day.

I hope these tips keep you healthy this holiday season!

Bugging Off!

Nicole

And yes, I am extremely happy with my amazing
alliteration abilities!(Ooops!I did it again! A)

Friday, December 7, 2012

A discussion as to the best way to handle environmental
contamination by Clostridium difficile can be at times the equivalent of
watching a soap opera.When it comes to
who believes what, who knows best, what is stated in current infection
prevention guidelines, newly published peer reviewed articles and of course
disinfectant manufacturing sales materials highlights the fact that two
seemingly similarly educated people can be complete polar opposites!While I’ve never been involved in a
discussion that has come to fisty-cuffs, I do have two pairs of 16oz boxing
gloves that I’d gladly provide if it would help come to a consensus!

I think with advancement and by this I mean our ability
to manufacture “better” disinfectants, our ability to improve test methods both
for disinfectant product efficacy but also for clinical specimen sampling and
disease diagnosis we become so enlightened with all the “new” stuff we forget
the importance of the basics.I think we
often need to be reminded of the basics.

While there is sufficient published science to support
that sodium hypochlorite at the correct dilution and contact time has the
ability to kill C.diff spores, it has not been until recent years that Health
Canada or the US EPA has approved a method to allow for actual label claims
against C.diff.We can now choose from
sodium hypochlorite, hydrogen peroxide and peracetic acid based formulations
with registered claims against spores.Certainly, from an infection prevention perspective this has meant advancement
in practices, but in the quest to find products that can KILL we have lost
sight of the importance of physical friction.More simply put, we have lost sight of the importance of how CLEANING,
how WIPING can and WILL remove spores from the surface.

Let’s be honest, to kill spores we need to increase the
concentration of chemical used.This
increase will result in less than stellar occupational health and safety
profiles for the products that are being used and will also have a direct
impact on the compatibility with the various surfaces the product will be
applied.

The 2010, SHEA-IDSA Guidelines for Clostridium difficile
states “The efficacy of cleaning is critical to the success of decontamination
in general, and thus user acceptability of disinfection regimens is key
issue”.When asked about a product’s
ability to kill, I have always stated that I do not care what a product kills,
if staff will not use the product as designed by the manufacturer, the label
claim is meaningless!Don’t get me wrong,
I am in no way saying that we should not use sporicidal agents in dealing with
C. diff.What I am saying is that we
need to consider more that what the product kills, but look at how effective
the product is at cleaning (thereby removing spores from the surface) and most
importantly, how will the staff that will be using these products daily for
long periods of time respond?A well
implemented infection control program requires that the products we choose are in
fact used!

It was with this that I was quite excited to read a
recently published study by Dr. William Rutala and his research team (ICHE,2012;33:1255-1258).The study compared
the importance of physical removal versus sporicidal inactivation of different
cleaning and disinfection chemistries.There was what I thought of as several key take home points – or “Ah-Ha”
moments.First, did you know that most
studies have quantitated the level of C. diff spore contamination on surfaces
to be<1Log10?Why then do Health Canada and the US EPA require
manufactures to achieve at least a 6 Log10 reduction against C.diff spores in
order to make a claim.If you didn’t
already know, a 6 log10 reduction implies we are chemically sterilizing the
surface.If we do not have that level of
contamination on surfaces to begin with why do disinfectants need to achieve
such a level of kill?As mentioned
earlier, to obtain sporicidal claims we need to increase the concentration of
chemical used.We are creating
disinfectant products that have increased occupational risks.Perhaps if the test method needed to obtain a
sporicidal surface claim was adjusted to provide a more realistic level of kill
based on actual surface contamination we would have sporicidal products that we
could use on a daily basis without the worry of occupational safety or material
compatibility issues.

Secondly, and to me most importantly, CLEANING
WORKS!The study showed that wiping
environmental surfaces, even with a non-sporicidal agent can eliminate
approximately 3 Log10 of C.difficile spores. Sporicidal agents provided a 3 Log10 to 6 Log10 reduction depending on
formulation and/or application with the most commonly used bleach wipe showing
just under a 4 Log10 reduction.

I’m not saying that we shouldn’t use sporicidal
agents.I’ve worked with enough
facilities in outbreak situation to know they work.However, have we set the bar to high in terms
of what is required with respect to obtaining a registered C. difficile claim?Are we knowingly, exposing our staff to
unnecessarily high concentrations of chemicals when as we know the level of
contamination on surfaces is significantly lower than the level of kill
required to obtain a label claim?Knowing that cleaning works, would we be wrong to develop protocols that
focus on the physical removal of spores for cleaning of isolation rooms and
utilize sporicidal agents for terminal cleaning, for outbreaks or for use on
wards with higher endemic levels of C. diff?I know facilities that do just that and do it well.